US teen birth rates (births per 1,000 females aged 15 to 19 years) decreased 7% overall from 2016 to 2017.1 Decreases occurred for teens of most racial groups races and for Hispanic teens. Despite these declines, racial/ethnic, geographic, and socioeconomic disparities persist. Achieving health equity, eliminating disparities, and improving the health of all groups is an overarching goal of Healthy People 2020External. Evidence-based programs and clinical services to prevent teen pregnancy through individual behavior change are important, but research is also shedding light on the role social determinants of health play in the overall distribution of disease and health, including teen pregnancy.

Disparities by Race and Ethnicity

In 2017, the birth rates for Hispanic teens (28.9 per 1,000) and non-Hispanic black teens (27.5) were more than two times higher than the rate for non-Hispanic white teens (13.2). The birth rate for American Indian/Alaska Native teens (32.9) was highest among all races/ethnicities.1

Birth rates for females aged 15-19, by race and Hispanic origin of mother: United States, 2016 and 2017

Social health determinants include a person’s age and the environment in which people are born, live, learn, work, play, and worship. The health determinants affect a wide range of health issues and quality-of-life outcomes and risks. (Healthy People 2020External). Certain social determinants, such as high unemployment, low education, and low income, have been associated with higher teen birth rates.2 Interventions that address socioeconomic conditions like these can play a critical role in addressing disparities observed in US teen birth rates.

Health Equity

Health equity is achieved when everyone has an equal opportunity to reach his or her health potential regardless of social position or other characteristics such as race, ethnicity, gender, religion, sexual identity, or disability. Health inequities are closely linked with social determinants of health. Learn more at the Community Guide websiteExternal.

Geographic Disparities

Disparities between U.S. states persist, with state-specific 2017 teen birth rates ranging from 8.1 in Massachusetts to 32.8 in Arkansas.1

Across counties, teen birth rates vary greatly:

Higher-rate counties are clustered in the South and Southwest, but high-rate counties also occur in states with low overall birth rates.2

From 2007 through 2015, the teen birth rate was lowest in large urban counties (18.9) and highest in rural counties (30.9). 3

From 2007-2015, the birth rate among teens in rural counties declined only 37%, compared with the decline in large urban counties (50%) and in medium and small counties (44%) during the same period.3

Socioeconomic Disparities

Socioeconomic conditions in communities and families may contribute to high teen birth rates. Examples of these factors include the following:

Low education and low income levels of a teen’s family.4

Few opportunities in a teen’s community for positive youth involvement.4

Teens in child welfare systems are at increased risk of teen pregnancy and birth than other groups. For example, young women living in foster care are more than twice as likely to become pregnant than those not in foster care.5

Taking Action to Eliminate Disparities and Address Social Determinants of Teen Pregnancy

Eliminating disparities in teen pregnancy and birth rates would do the following:

Help achieve health equity.

Improve the life opportunities and health outcomes of young people.

Reduce the economic costs of teen childbearing.

Efforts that focus on social health determinants in teen pregnancy prevention efforts, particularly at the community level, play a critical role in addressing racial/ethnic and geographical disparities observed in teen births in the United States.